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The following is a summary of “Outcomes of coronary artery bypass grafting (CABG) in patients with OSA-COPD overlap syndrome versus COPD alone: an analysis of US Nationwide Inpatient Sample,” published in the April 2024 issue of Pulmonology by Yeh et al.

Coronary artery bypass grafting (CABG) poses particular challenges for patients with obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD), often leading to unfavorable postoperative outcomes. This study aimed to scrutinize the in-hospital outcomes of individuals with COPD alone compared to those with overlapping OSA-COPD following CABG procedures.

Utilizing data from the US Nationwide Inpatient Sample (NIS) spanning from 2005 to 2018, information on adults aged 18 years and older who underwent elective CABG with COPD was extracted. Patients were categorized into two cohorts: those with OSA-COPD overlap and those with COPD alone. Propensity score matching (PSM) was applied to ensure a balanced representation of group characteristics. Logistic and linear regression analyses were then employed to assess the associations between various study variables and inpatient outcomes.

Following PSM, data from 2,439 patients with OSA-COPD overlap and 9,756 with COPD alone were analyzed. Upon adjustment, OSA-COPD overlap demonstrated a significantly heightened risk of overall postoperative complications, respiratory failure/prolonged mechanical ventilation, non-routine discharge, and acute kidney injury (AKI). However, patients with OSA-COPD overlap exhibited a lower risk of in-hospital mortality compared to those with COPD alone. Notably, the two groups had no notable differences in the risk of postoperative atrial fibrillation (AF) or pneumonia. Stratified analyses further revealed that OSA-COPD overlap was associated with increased risks of respiratory failure/prolonged mechanical ventilation and AKI across various subgroups.

In the context of CABG procedures among US adults, individuals with OSA-COPD overlap face heightened risks of non-routine discharge, AKI, and respiratory failure/prolonged mechanical ventilation compared to those with COPD alone, albeit with a lower risk of in-hospital mortality. Notably, no increased risk of postoperative AF was observed.

Source: bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-024-02994-y